• 한국산업보건학회지
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• 제3권2호
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• pp.166-176
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• 1993

In order to investingate the renal dysfunction in workers exposed to aromatic organic solvents, 105 male exposed workers and 109 controls were participated in this study. This study was conducted to examine the correlation among the concentration of aromatic organic solvents in air, worker's urinary NAG activity and urinary hippuric acid. The results were as follows : 1. The exposure level of aromatic organic solvent mixture caculated by the equation proposed by ACGIH was ranged from 0.27 to 0.54 and toluene concentration was ranged from 18.3ppm to 48.3ppm. 2. NAG activity in the urine of control and exposed group were $36.1{\pm}14.2nmolMU/mg$ creatinine and $52.4{\pm}26.1nmolMU/mg$ creatinine, respectively. Hippuric acid concentration in the urine of control and exposed group were $191.1{\pm}194.2mg/g$ creatinine and $789.3{\pm}784.1mg/g$ creatinine, respectively. 3. Correlation coefficent between the exposure level of aromatic organic solvent mixture was significantly related to urinary NAG activity(r=0.542) and urinary hippuric acid(r=0.752). 4. Correlation coefficient between NAG activity and hippuric acid concentration was 0.357. This study suggested that urinary NAG activity was a good renal function index for aromatic organic solvents exposure and urinary hippuric acid was an index for the biological monitoring of toluene exposure.

• The Korean Journal of Physiology
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• 제16권2호
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• pp.177-186
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• 1982

The effect of ethacrynic acid (EA) on the renal secretion of PAH was examined in cat kidney. $C_{PAH}$ and $T_{PAH}$ were measured before and after infusion of EA $(0.5{\sim}50mg/kg)$ through the femoral vein. The following results were obtained: 1) In the dosage range of 0.5 to 25 mg/kg, EA increased the urine flow, and sodium and potassium excretion in dose-dependent manner, but the glomelular filtration rate was decreased as the dosage of EA was increased. 2) $C_{PAH}$ and $T_{PAH}$ were decreased by EA in the dosage range of 3 to 25 mg/kg and 1 to 50 mg/kg, respectively, in dose·dependent manner with the dosage to cause 50% inhibition of about 5 mg/kg. 3) With dosage of 0.5mg/kg, EA appeared to exert a great effect on diuretic response without the influence on $T_{PAH}$. At 10min after infusion of EA, a potent diuretic effect appeared, while $T_{PAH}$ did not show a significant change. These results suggest that the action mechanism of EA on tubular secretion of PAH may be different from that on natriuresis. 4) With dosage of 5 mg/kg, EA did not inhibit the Na-K-ATPase activity in microsomal fractions from both cortex and medulla. 5) The double reciprocal plot ($l/T_{PAH}$ versus $l/P_{PAH}$) suggested that EA inhibited the P AH secretion by a competitive pattern. However, probenecid, a prototypic inhibitor of the organic acid pump, had no influence on both the inhibitory effect of $T_{PAH}$ and the natriuretic effect by EA. These results suggest that in vivo EA altered tubular secretion of P AH through interactions with receptors that are not identical with the Na-K-ATPase.

• Biomolecules & Therapeutics
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• 제10권1호
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• pp.19-24
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• 2002

The effects of a newly synthesized $H^+/K^+$ ATPase inhibitor,1-(2-methyl-4-methoxypheny)-4-[(3-hy-droxypropyl)amino] -6-methyl-2,3-dihydropyrrolo (3,2-c) quinoline (DBM-819) , on the central nervous system, isolated smooth muscle, cardiovascular and digestive systems and renal function were investigated in various experimental animals. Oral administration of DBM-819 had no effect on the central nervous system except body temperature of mice slightly decreased at doses of 15 and 50 mg／kg. DBM-819 produced a moderate analgesic effect in acetic acid-induced writhing test in mice at 50 mg／kg (p.o.). In conscious rats, DBM-819 (15 and 50 mg／kg, p.o.) showed a slight increase in blood pressure and a small decrease in heart rate. DBM-819 had an significant effect on agonist-induced contraction of guinea pig ileum at $1.5{\times}10^{-5}g/ml.$ No significant effect of DBM-819 (5 and 15 mg／kg, i.p) on urinary volume or urinary excretion of $Na^+,\;K^+$ and Cl- was observed in rats. DBM-819 had no significant effect on intestinal transport of a semisolid meal in mice at 15 and 50 mg／kg (p.o.). These findings suggest that DBM-819 exerts no significant pharmacological effects on the central nervous system and renal function at 15 mg／kg (p.o.), but produces some effects on the smooth muscle and circulatory system.

• Childhood Kidney Diseases
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• 제18권2호
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• pp.111-115
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• 2014

요로기형 또는 급성신우신염이 있는 어린 영아에서 신세뇨관 기능 미성숙이나 일과성 가성저알도스테론혈증에 의해 고칼륨혈증이 흔하지 않게 발생할 수 있다. 고칼륨혈증은 증세가 뚜렷하지 않지만, 골격근이나 심장기능에 치명적인 영향을 줄 수 있어 즉각적인 처치를 필요로 한다. 고칼륨혈증 치료에 fludrocortisone을 적용하는 경우는 저알도 스테론혈증에 해당하였으나, 혈중 알도스테론농도 변화없이 세뇨관의 칼륨 배설 기능 미성숙에 의한 고칼륨혈증에 대한 사례는 문헌고찰상 없었다. 본 증례에서는 급성신우신염으로 입원한 후 지속적인 고칼륨혈증과 정상 혈중알도 스테론농도를 보인 25일 영아에서 fludrocortisone로 처치한 후 양호한 경과가 관찰되어 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.840-844
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• 2010

Purpose: Microalbuminuria is defined as increased urinary albumin excretion (30-300 mg/day) or microalbumin/creatinine ratio (30-300 mg/g) in a spot urine sample. Although microalbuminuria is a predictor of clinical nephropathy and cardiomyopathy, few studies have investigated microalbuminuria in children with urinary tract infection (UTI). Therefore, we compared the spot urine microalbumin/creatinine ratio in pediatric UTI patients with that of control subjects. Methods: We investigated the correlation between the ratio in children with UTI and age, height, weight, blood pressure, glomerular filtration rate (GFR), hematuria, vesicoureteral reflux, renal parenchymal defect, and renal scar, and its predictability for UTI complications. Results: We studied 66 patients (42 boys, 24 girls) and 52 healthy children (24 boys, 28 girls). The mean microalbumin/creatinine ratio in UTI patients was statistically significantly increased compared to the control group ($340.04{\pm}321.36mg/g$ vs. $225.68{\pm}154.61mg/g$, $P$=0.0141). The mean value of spot urine microalbumin/creatinine ratio ($384.70{\pm}342.22mg/g$ vs. $264.92{\pm}158.13mg/g$, $P$=0.0341) in 1-23 months age patient group showed statistically significant increase compared to control group. Microalbumin/creatinine ratio showed negative correlation to age (r=-0.29, $P$=0.0167), body surface area (BSA) (r=-0.29, $P$=0.0173) and GFR (r=-0.26, $P$=0.0343). The presence of hematuria ($P$=0.0169) was found to be correlated. Conclusion: The spot urine microalbumin/creatinine ratio in children with UTI was significantly greater than that in normal children, and it was positively correlated with GFR. This ratio is a potential prescreening and prognostic marker in UTI patients. Further studies are required to validate the predictability of microalbuminuria in pediatric UTI patients.

• 한국콘텐츠학회논문지
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• 제19권6호
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• pp.461-470
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• 2019

신장질환은 당뇨병환자에서 흔한 합병증이며, 알부민뇨 배설의 증가, 사구체여과율의 감소가 특징적이다. KDIGO 분류에 따라 6기 국민건강영양조사 원시자료를 이용하여 알부민뇨와 사구체여과율에 따라 특성을 분석하였다. 당뇨환자를 KDIGO의 분류에 따라, Low risk 72.0%, Moderate risk 19.3%, High risk 5.6%, Very high risk 3.0%이었다. 당뇨병 유병기간이 길어질수록 Low risk는 74.7%에서 52.2%로 감소하였고, Moderate~Very high risk는 25.4%에서 47.8%로 상승하였다. 위험요인은 CKD stage 1 (HR 2.064) ~ stage 4 (HR 11.049)로 고혈압의 위험도가 가장 높았다. 고혈압 유병기간에 따라 신장질환의 발생빈도는 상승하였고, 적정 혈압을 유지하는 군에서 신장질환의 위험도 0.42가 감소하였다. 고혈압 환자에서 적정 혈압으로 관리하는 군이 그렇지 않은 군보다 42%의 신장질환의 감소효과가 있었다. 그러므로 고혈압을 적정혈압으로 조절 및 관리하는 것이 신장질환의 예방에 있어 중요하다.

• Childhood Kidney Diseases
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• 제1권1호
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• pp.17-23
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• 1997

목적 : IgA 신병증은 다양한 임상 소견을 보일 수 있으며 초기에는 대부분 예후가 양호한 것으로 알려졌었으나 현재는 발병 20년후 20-30%가 말기 신부전증을 초래한다고 알려져 있다. IgA 신병증의 예후를 예측하기 위한 여러 조사에서 발병 초기의 심한 단백뇨, 고혈압, 조직 병리학 상의 심한 변화 등이 있을 경우 예후가 나쁘다고 하였다. 1996년 Yagame등은 IgA 신병증에서 새로운 조직 병리학적 분류를 하였고 WHO 분류 방법이 사구체 병변을 중심으로 한데 비해 세뇨관과 간질의 변화까지 포함하고 있어 이들의 분류 방법이 더 우수하며 추적관찰 결과 만성 신부전의 예후 인자로써 유용하다고 발표하였다. IgA 신병증에서 임상 증세, 검사 소견, WHO 및 Yagame 등의 조직 병리학적 분류 등과 추적 관찰시 만성 신부전과의 상관 관계를 알아보고자 하였다. 방법 : 1984년 1월부터 1996년 2월까지 소아과에 입원하여 신생검상 메산지움에 IgA가 현저히 침착되어 있어 IgA 신병증으로 진단된 환아 79명을 대상으로 평균 27개월의 추적관찰시 신 기능이 정상인군(73례)과 만성 신부전으로 진행한 군(6례)을 서로 비교하여 IgA 신병증에서의 예후 예측 인자에 대하여 알아보고자 하였다. 결과 : 1) 성별, 나이, 증상기간 등은 양군간 차이가 없었으나 내원시 고혈압이 있을 경우 만성 신부전으로의 진행이 많았다. 2) 내원시에 여러 임상 검사중 심한 단백뇨가 만성 신부전으로의 진행이 많았다. 3) WHO 및 Yagame 등의 조직 병리학적 분류 모두 소아 환자에서는 예후와의 관련을 찾을 수 없었다. 결론 : 이상의 결과로 보아 IgA 신병증 환아에서 내원시에 심한 단백뇨, 고혈압이 있을 경우 추적 관찰 결과 예후가 좋지 않았다. 그러나 본 연구의 경우 치료에 대한 평가가 이루어지지 않았고 대상 환아가 적었기에 향후 이를 포함하는 광범위한 연구가 진행되어야 할 것으로 사료된다.

• Childhood Kidney Diseases
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• 제3권1호
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• pp.72-79
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• 1999

서 론 : 방광요관역류로 인한 신조직의 손상은 소아에서 말기신부전 및 신성 고혈압의 중요한 원인중 하나이며 방광요관역류에 의한 신장변화는 조기에 발견될 경우 그 예방이 가능하다. 현재까지는 주로 반복적이며 항생제 치료에 잘 조절되지 않는 요로감염에서 방광요관역류를 의심하고 진단을 위한 방사선학적 진단법을 시행하였으나, 단발성의 요로감염 환아에서도 역류가 진행되어있는 경우를 경험하게 되므로, 요로감염이 있는 환아에서 방광요관역류를 조기에 의심할 수 있는 진단방법이 요구되고 있다. 본 연구에서는 요로감염이 있는 환아를 대상으로하여 방광요관역류가 있는 군과 방광요관역류가 없는 군에서 뇨중 ${\beta}_2$-microglobulin(${\beta}_2$-MG)을 측정하여 의미있는 차이가 있는지를 알아보고 그 차이가 요로감염이 진행중인 환아에서 방광요관역류의 존재의 지표로 이용될 수 있는지 여부를 확인하고자 하였다. 대상 및 방법 : 요로감염으로 처음 내원하여 치료를 시작하였던 57명의 환아를 대상으로 하였으며, 전례에서 방사선학적인 검사(복부초음파, DMSA scan 및 VCUG)를 시행하여, 단순 요로감염환아군과 요로감염이 있으면서 방광요관역류가 발견되었던 환아군으로 구분하였고, 각 군간의 무작위 추출 뇨중 ${\beta}_2$-MG치와 뇨중 creatinine치의 비율로 그 배설율을 비교하였다. 대상환아중 신독성 약물을 사용하였던 환아 및 ${\beta}_2$-MG의 생성 및 배출에 영향을 미칠 수 있는 질환을 앓고있는 환아는 본 연구에서 제외하였다. 결 과 : 전체 대상환아 57명중 남녀비는 28:29였고 평균연령은 $4.27{\pm}4.24$세 였다 요로감염이 배양검사상 확진된 례가 44례 였고, 임상적으로 요로감염이 의심되었던 례가 13례 였으며 배양된 균주는 E.coli($43.9\%$)와 Enterococcus($15.8\%$)가 가장 많았다. 방광요관역류는 12례($21.1\%$)에서 발견되었으며 평균연령은 $2.97{\pm}2.82$세로 단순 요로감염 환아군의 평균연령 $4.62{\pm}4.51$세에 비하여 낮은 경향을 보였고, 남녀비는 3:1로 남아가 많았다. 무작위 추출뇨중 평균 ${\beta}_2$-MG치는 단순 요로감염군 $0.19{\pm}0.16mg/dL$, 방광요관역류군 $2.2{\pm}5/91,g/dL$로 두군간에 의미있는 차이를 보였으며(P=0.03), ${\beta}_2$-MG/creatinine비는 단순 요로감염군은 $3.93{\pm}3.44$, 방광요관역류동반군은 $32.41{\pm}25.7$로 두군간에 의미있는 차이를 나타내었다(P=0.007). 두군간의 배양된 균주 및 균배양 양성율과 혈청 크레아틴치의 의미있는 차이는 없었다. 결 론 : 요로감염환자에서 무작위 추출뇨중 ${\beta}_2$-MG치와 배설율은 방광요관역류의 존재를 조기에 의심할 수 있게하는 검사법이며, 기존의 24시간뇨를 이용하여 측정하는 방법보다 간편하고 비용이 저렴하여 방광요관역류의 검색진단법으로서 유용하리라 생각되며 소아 고혈압과 말기신부전의 원인 질환중 많은 부분을 차지하고 있는 방광뇨관역류의 조기진단 및 조기치료로 그 이행율을 감소시키는데 많은 기여를 할 수 있을 것으로 기대된다.

• 동의생리학회지
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• 제14권2호통권20호
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• pp.189-198
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• 1999

Aminoglycosides, including gentamicin, have been used as antibiotics for the various infections by gram-negative bacteria. However, there are some restrictions for using these drugs. Gentamicin, a typical aminoglycoside, has the side effect of nephrotoxicity, including polyuria, glycosuria, proteinuria, glomerulonephritis, and uremia. The aims of this study were to examine the prevention or reduction effects of Jinmootang on the gentamicin-induced nephrotoxicity and to investigate the possible mechanisms on the effect of Jinmootang. The subcutaneous injections of 60mg of gentamicin per kg of boby weight to Sprague-Dawley rats for 8 days induced typical symptoms of nephrotoxicity by aminoglycosides. 0.6ml of water extract Jinmootang (100ml/chup) was orally treated in the experimental animal. 24-hour urine was collected with the metabolic cage and plasma was sampled from the abdominal aorta. The plasma concentration of sodium was significantly decreased by the treatment of gentamicin but it was not-significantly changed by the treatment of Jinmootang to the animal. The concentration of potassium was greatly decreased in the gentamicin-treated animals. However. it was returned to the normal level in the Jinmootang-treated animals. The concentrations of creatinine and urea were increased by gentamicin treatment. But, Jinmootang reduced these concentrations. Nevertheless, the osmolalities of plasma in both group were not different from each other. Even though the plasma concentration of aldosterone was not significantly changed, the mean value was increased by the gentamicin intoxication. The concentration of aldosterone was decreased by the treatment of Jinmootang. The reduction of aldosterone level in plasma could be a factor to improve the hypokalemia. The fractional excretion of potassium was much higher than normal by the treatment of gentamicin and it was decreased by 50% in the Jinmootang-treated rats. Therefore, the reabsorption of potassium was significantly increased by the treatment of Jinmootang, even though the filtered load of potassium in the experimental group was much highter than control. Even though the concentration of plasma aldosterone was decreased by the treatment of Jinmootang, the fractional excretion of sodium was not increased, slightly lower. These data suggested that Na reabsorption was increased in the proximal tubule by Jinmootang. The filtered load of glucose in the Jinmootang-treated group was greater than in control. Nevertheless, the fractional excretion of glucose in the experimental group was not different from that in control. These results indicate that glucose reabsorption was increase in the proximal tubule by Jinmootang treatment. The results of this study suggest that Jinmootang could improve the some nephrotoxic symptoms induced by gentramicin treatment. Hypokalemia, the reduced glomerular filtration rate, and dysfunctions of renal proximal tubule and distal nephron were significantly recovered to normal level. The increase of glomerular filtration rate by Jinmootang might contribute to eliminate the waste product, including creatinine and urea, and/or gentamicin through the kidney.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권1호
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• pp.7-10
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• 1993

The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.